Healthier Communities: A NewPublicHealth Conversation with the Y's Monica Vinluan

The Healthier Communities Initiatives of the Y are built on the concept that local communities can work together to create healthy choices and support the pursuit of healthy lifestyles. More than 160 Ys are working in collaboration with community leaders to make changes in policies and the physical surroundings in those communities to help improve the health and lives of everyone.

Pioneering Healthier Communities, launched in 2004, focuses on collaborative engagement with community leaders, and the role policy plays in sustaining change. Statewide Pioneering Healthier Communities, launched in 2009, is funded by the Robert Wood Johnson Foundation, with an aim of addressing the childhood obesity epidemic through policy and environmental changes that will have implications for communities, states and the nation. Communities in Connecticut, Kentucky, Tennessee, Illinois, Michigan and Ohio are participating in the program.

Some examples of programs that have emerged from the initiative include:

Burlington, KY: The Burlington SPHC represents a collaboration of partners including the Northern Kentucky Health Department, the Early Childhood Councils in Boone, Kenton, and Campbell counties, one school district, 20 individual schools in three counties and the Kentucky Department of Public Health. The collaboration has resulted in the improvement of menus in at least 10 childcare centers and has provided concrete examples of menu changes for other centers. SPHC provided funding to train staff for a pre-assessment of the center menus, measuring amount of fat, fresh fruits and vegetables in meals, and types of beverages served. A number of early childhood centers agreed to change their menus by February 1, 2012, and centers that did so received a cash incentive, paid by a different funder. The revised menus will be compared with the pre-assessment of menus to determine the success of the program.

In Port Huron, Michigan, the SPHC conducted assessments in 17 schools, 5 afterschool locations and 5 neighborhoods which indicated need for improved in-school and out-of school policy. The SPHC group has worked to increase physical activity time being offered throughout the school day and in out-of school programming. They have doubled their required physical education time – from 1 to 2 hours per week – and have seen compliance in 10 out of 11 elementary schools and 1 of 3 middle schools, and the YMCA of the Blue Water Area has added an extra hour of play time at four after-school sites.

In Marion, Ohio, SPHC continues to build community momentum for childhood obesity prevention, including organizing effort across groups to move the community forward. Using local data, including the County Health Rankings, the SPHC confirmed additional effort and resources were needed in certain disadvantaged parts of the city, including better access to fruits and vegetables and improved areas for outdoor play. In response, the SPHC helped create four new community gardens, has worked to improve the built environment by increasing public awareness through media and educating decision makers and has advocated for a Complete Streets policy and a Safe Routes to School policy.

NPH: What are some of the leading practices you use across the healthier communities initiatives that you have been putting into play?

Monica Vinluan: We actually have seven leading practices of our healthier communities work: Our first one is to start with a shared, compelling vision and a spirit of inquiry.

The second is to adapt to emerging opportunities, as they present themselves in both the political and social spheres. The third is borrowing from others. All of our work with healthier communities is really organically grown and very much grassroots-driven and grassroots-defined. So, if there is already an amazing coalition taking place in that community, our work doesn’t seek to supplant it or replace it but rather seeks to try to push it to another level.

The fourth leading practice is around engaging cross-boundary leaders, so all of our work involves multi-sectoral leadership teams. So, the Y is just one of the players in the collaboration in all of our communities, and we really push the communities to be engaged in different sectors and different organizations and agencies and nonprofit groups and private industry to try to find common solutions.

Another is really about serving in multiple roles. So, sometimes the role of the Y is the role of the convener. Sometimes, the role of the Y is actually the leader in trying to address some gaps in opportunities, and sometimes the Y just serves in the background and really helps in the role of supporting what’s already going on.

NPH: What are some of the other leading practices?

Monica Vinluan: Another leading practice is to use data to guide and not drive the effort, so we have lots of different assessment tools that we offer to our community sites and offer training around how to engage in community assessments, but really, the point of the assessment is to get a better understanding and a better sense of what the direction the community wants to go in. Our philosophy is really around using that data to guide their efforts and not be the exclusive driver of their efforts.

And the final practice is developing leadership structures that distribute ownership and action This work has to be a distributed leadership model so that everyone at the table has a role to play in leading different aspects and different components of the work because it’s only with leadership that someone will have that ownership as well as instill that sustainability in the effort.

NPH: What is it about the identity of the Y that allows it to be involved in these initiatives as both a convener of multiple partners and the advocate at the local level?

Monica Vinluan: This is part of the foundation of who the Y is. The Y is really an organization designed for the purpose of serving the community that it exists in and indeed our cause is to strengthen community. We do that in three ways – through youth development, healthy living and social responsibility. Those are the three backbones, the three fabrics that exist throughout our entire movement.

NPH: Do you have an example of a community that’s achieving improved outcomes?

Monica Vinluan: We have quite a variety of different examples of that. We have some communities that have been really engaged in policy systems, environmental changes, to try to improve access to fresh fruits and vegetables, for example, to enable more kids to be able to walk to school, to be able to make sure that more kids have access to physical education and physical activity opportunities during the school day.

NPH: What value do the County Health Rankings bring to your work?

Monica Vinluan: It really falls in the category of confirming the approach that we’ve been taking with the healthy communities work and lots of other initiatives. And that confirmation is around how many different sectors of society need to be involved in the solutions. And, it also confirms that there are many different policy options to pursue because there’s not just one answer. The County Health Rankings show all those different factors. I really think the Rankings confirm what we know is a valid approach, the multi-disciplines that need to be involved, the multiple policy angles that need to be taken, and really about how every solution needs to be tailored by each community. There’s not one solution and there’s not one answer to this very complex problem of how to design and create healthier communities.

For us, it’s another critical tool in the tool belt to help identify and understand the gaps and opportunities that exist in each county.